United Common Ground Interest Form

Please complete the contact information portion of this form first, then indicate which roles on United Common Ground interest you the most. Once you submit this form, our advisor will contact with you shortly to invite you to one of our meetings and to let you know more about helping out on our staff.

Please enter your first and last name.
Please enter your 7-digit student ID number listed on your OneCard.
Please enter your home phone number in the following format: (608) 246-6576
Please enter your cell phone number in the following format: (608) 246-6576
Enter your street address (Example: 3550 Anderson St.)
Enter your 5-digit zip code
Enter the e-mail address you would like us to use to contact you
Please list the campus where you attend most of your classes
What program are you attending at Madison College?
How many credits are you enrolled in this semester?
Please indicate which United Common Ground roles interest you the most.